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฀ Attorney: _________________________ Bar No.: _____________ Defendant’s Name: Mailing Address: City and Zip Code: E-mail Address: Telephone No.

FOR COURT USE ONLY

SUPERIOR COURT OF CALIFORNIA, COUNTY OF MONTEREY Marina Division – 3180 Del Monte Blvd., Marina, CA 93933 The People of the State of California vs.

Angaddeep Singh Bains

, Defendant APPLICATION TO REDUCE THE TRAFFIC COURT FINE/CIVIL ASSESSMENT CASE NUMBER: (Ability to Pay Determination); CONFIDENTIAL FINANCIAL DECLARATION AND ORDER (California Rule of Court 4.106 and 4.335) TR-19TR004347 CONFIDENTIAL DOCUMENT You must COMPLETE EACH LINE and ATTACH RELEVANT FINANCIAL DOCUMENTS that you wish the court to consider. If you are getting public benefits, are a low-income person, or do not have enough income to pay for your basic household needs and your traffic fines/assessments, you may use this form to request the Court vacate or reduce the fines/Civil Assessment on your traffic matters. The court will consider your due diligence in appearing or paying and your financial circumstances. Fully and truthfully complete the Financial Declaration below so the court can determine your ability to pay. You may be required to provide further information or appear in court for a hearing. Any order made pursuant to this request will have the same force and effect as a judgment in a civil action.

I am requesting the Court vacate or reduce the Fines/ Civil Assessment based upon the following information: 1. YOUR INFORMATION: Singh Bains Name: Angaddeep _____________________________________ Other Names:_______________________________ 4139 Sierra Gold Drive, Antelope, CA 95843 Address: _________________________________________________________________________________________ Date of Birth: _________________ Home Phone: _________________ Driver’s License Number: __________________ Married: (__ Yes__No) Spouse Name: _________________________________________________________________ 2. YOUR JOB: N/A N/A Job Title:______________________________ Name of Employer:_____________________________________ _ N/A Employer’s Address: ________________________________________________________________________________ 3. What Court fines or assessments are you asking to be waived or reduced? 238.00 ฀ Traffic Fine in the amount of: $______________ ฀ Civil Assessment in the amount of: $_________________ 4. WHY ARE YOU ASKING THE COURT TO REDUCE YOUR FINE OR WAIVE CIVIL ASSESSMENTS? (check all that apply) a. ฀ My income is from (check all that apply and attach proof): ฀ Food Stamps ฀ General Assistance ฀ TANF (Tribal) ฀ SSI ฀ IHSS ฀ SSDI ฀ Medi-Cal ฀ CalWORKS ฀ CAPI ฀ Retirement ฀ Wages ฀ Self Employment ฀ Scholarships/Grants ฀ Rental Income b. ฀ My gross monthly household income (before deductions for taxes) is less than the amount listed below. (If you check 4b, you must fill out question, 5, 6, 7, 8, 9, and 10 below Family Size Family Income Family Size Family Income Family Size Family Income 1 $1,256.26 3 $2,127.19 5 $2,997.92 2 $1,691.67 4 $2,562.51 6 $3,433.34 c. ฀ I do not have enough income to pay for my household’s basic needs and the court fees. I ask the court to: (check all that apply and you must fill out questions 5, 6, 7, 8, 9, and 10 below: ฀ Waive all fines. ฀ waive the civil assessment. Form Approved for Use TR-182 New. March 2017

APPLICATION TO VACATE OR REDUCE FINE/CIVIL ASSESSMENT, CONFIDENTIAL FINANCIAL DECLARATION AND ORDER (TRAFFIC)

Monterey County Superior Court

d.

฀ Reduce some of the fines. ฀ Let me make payments over time. Describe reasons establishing good cause to vacate or reduce your fine/civil assessments: I am a college student at CalPoly and this is my first ticket, ever. I understand my mistake and will not let it happen again.

I declare under penalty of perjury under the laws of the State of California that the information provided on this form and all attachments are true and correct. Signature:________________________________ Date:______________ 5.

YOUR GROSS MONTHLY INCOME List source and amount of ANY income you get each month, including: wages or other income from work before deductions, spousal/child support, retirement, social security, disability, unemployment, military basic allowance for quarters, veterans payments, dividends, interest, trust income, annuities, net business or rental income, reimbursement for job-related expenses, gambling or lottery winnings, etc. University FAFSA 400 _____________________ $_____________

(a) (b) _____________________ $_____________ (c) _____________________ $ _____________ (d) _____________________ $ _____________ (e) _____________________ $ _____________ 400 YOUR TOTAL MONTHLY INCOME $ _____________

8. YOUR MONEY AND PROPERTY: 5000 (a) Cash: $____________ (b) All financial accounts (list bank name and amount): 7000 1. Chase _______________________ $____________ 2. ________________________ $____________ 3 ________________________ $____________ (c)Cars, boats and other vehicles: Make/Year Value N/A 1._________________ $__________ 2._________________ $__________ 3._________________ $__________

Amt. Owing $__________ $__________ $__________

(d) Real Estate: Address Value Amt. Owing N/A 1.__________________ $__________ $__________ 2.__________________ $__________ $__________

6.

HOUSEHOLD INCOME

List the income of all other persons living in your home who depend in whole or in part on you for support, or on whom you depend in whole or in part for support.

NAME AGE RELATIONSHIP INCOME/Month Satpal 50 Mom 1400/month (a)______________________________________________ (b)______________________________________________ (c) _____________________________________________ 1400 TOTAL MONTHLY INCOME OF OTHERS $______________

Form Approved for Use TR-182 New. March 2017

(e)Other personal property (jewelry, furniture,, stocks, bonds, etc) Description Value Amt. Owing School Laptop 2200 1000 1.__________________ $___________ $___________ 2.__________________ $___________ $___________ 9. YOUR MONTHLY DEDUCTIONS AND EXPENSES: a. List any payroll deductions and the monthly amounts n/a 1. __________________________ $__________ 2. ___________________________ $ __________ 3. ___________________________ $ __________ 4. ___________________________ $ ___________ 650 b. Rent or house payment & maintenance $________ 100 c. Food and household supplies $________ 75 d. Utilities and phone $________ 50 e. Clothing $________ 20 f. Laundry and cleaning $_________ 0 g. Medical and dental expenses $_________ 0 h. Insurance (Life, health, etc.) $_________ 0 i. School, child care $_________ 0 j. Child, spousal support paid $_________ 50 k. Transportation, gas, auto repair/insur $_________ l. Installment payments (list each below): n/a 1. ____________________________ $_________ 2. ____________________________ $_________ 3. ____________________________ $_________ n/a m. Wages withheld by Court order $_________ n. Other monthly expenses (list each below):

APPLICATION TO VACATE OR REDUCE FINE/CIVIL ASSESSMENT, CONFIDENTIAL FINANCIAL DECLARATION AND ORDER (TRAFFIC)

Monterey County Superior Court

7.

1800 TOTAL MONTHLY HOUSEHOLD INCOME $___________

1. _____________________________ $_________ 2. _____________________________ $_________ 3. _____________________________ $_________ 945 10. TOTAL MONTHLY EXPENSES $___________

ORDER Based upon the information provided by the defendant, the following determination is made: ฀

Defendant fine of $________________ is reduced to ___________________________.

฀

Defendant is ordered to pay the fine of $___________ in equal monthly installments of $___________ on the _____ day of each month starting _______. If you miss a payment the total remaining amount becomes immediately due.

฀

The civil assessment of $______ is waived.

฀

Your request is denied because it is incomplete. You have ten (10) calendar days from the date this form was mailed to submit the following:__________________________________________________________________

฀

Your request is denied.

฀

Set for hearing on ___________________________, 20___ at 10:00 a.m., in Dept. 20, Marina Traffic Division, 3180 Del Monte Blvd., Marina, CA.

Dated: ______________________

Form Approved for Use TR-182 New. March 2017

_____________________________________________ Traffic Commissioner of the Superior Court

APPLICATION TO VACATE OR REDUCE FINE/CIVIL ASSESSMENT, CONFIDENTIAL FINANCIAL DECLARATION AND ORDER (TRAFFIC)

Monterey County Superior Court...